The effect of diet on PCOS

I still can't believe today that my hormones have corrected themselves. It seems so surreal!

It is just so amazing that this can be corrected with diet. Yes, I am also on metformin, but my doctor is convinced that this is due in no small part to my diet and weight loss.

So if you are reading this and have PCOS, why not give it a try? If you're in need of some encouragement, here are my top ten reasons I think you should go low G.I.:

1. You can correct your screwed up hormones (no offense, I'm sure your hormones are lovely, but you know what I mean).



2. You can feel better physically (less fatigue, more energy).



3. You can feel like you are actually doing something to help your fertility (if you're like me, this is great while you're anxiously awaiting that next doctor's appointment).



4. You can lose tons of weight!



5. You can buy all new clothes (I know this might be a negative if money is an issue, but I also now find enjoyment from just trying clothes on and not buying them!).



6. You can fit in your skinny clothes (it helps financially if you saved them, as long as they're not totally out of style. Some of mine definitely were).



7. It may seem like you have to give up all yummy food, but that is not the case. I promise.



8. Did I mention you can lose tons of weight?



9. No matter what, you'll be much healthier (PCOS does put us at risk for diabetes and heart disease, after all).



10. You might end up pregnant! Isn't that why we're all here??

I know it was by the grace of God that I was able to pull this off. I don't take that for granted or credit myself. While I was complaining about the Lord not hearing my prayers, he was blessing me in this way - with will power, with the ability to be satisfied with low G.I. foods, with quick weight loss. For me, the motivation to get pregnant surpassed everything else.

I am so thankful that I found my doctor and that he very matter-of-factly told me to start this diet immediately upon leaving his office. It is so apparent that God was involved every step of the way. So maybe God is using me to encourage one of you to do this as well!

I'm sorry for always talking about my diet. It probably is getting annoying! But I wanted to show you one more thing - a before and after picture of my weight loss (I take one every month and wear the same clothes every time, although in this most recent one I had to switch to different jeans since the others were too big):

It's not as dramatic as it could be because the one on the left is from almost two months into the diet, after I'd already lost 17 pounds, but you get the point. I wish I'd taken one at the very beginning to show the full 35 pounds (and counting) I've lost, but at that point I wasn't really into posing for full-body photos!

Well, gotta go do some baking. Yes, you can still bake (and eat the results) on this diet!

News

So we had the homestudy today. It went fine. We basically just answered 50 questions about our relationship. Some of the time I felt like I was answering the interview question during a beauty pageant - trying quickly to come up with a good, concise answer without sounding completely unintelligent - while the rest of the time I felt like I was at a job interview. There were a lot of those "what is your greatest weakness" type of interview questions where everyone answers, "Well, I'm a perfectionist..." or "I just expect so much from my co-workers..." So we tried to answer honestly while balancing not coming across like weirdos yet also not seeming too perfect (I think I talked about fighting two times, but if someone said they never fought I hope that would be a red flag!). We were also given tons of paperwork which we need to finish by our third appointment. Things are moving along quickly, though, as our second homestudy appointment will be two weeks from today.

If it seems like I am moving through that pretty quickly, well, I am (normally I'm not exactly short-winded, but it's not like I had to tell you all that). Not to take anything away from it, but my focus tonight has shifted a little to some amazing news.

My blood work came back perfect. That's right. It's all normal.

My doctor's office called me tonight and left a message. Since I didn't answer in time, I seriously whimpered and cried for the next twenty minutes at the prospect of having to wait until morning to call them back (it was after hours) for what I assumed would be my test results. As I was just beginning to calm down, my phone rang again. It was the nurse.

Nurse: "Dr. B wanted me to call and let you know that your lab results are in. [Holding my breath at this point] The tests came back normal. Everything was perfect. It says here to continue your medicine and it also says that you can go ahead and try to... conceive? Is that the word he wrote? Conceive?"

Me: [In shock at this point] "Yes, that's the word."

Nurse: "Oh, you are starting to try to conceive. Okay."

Even in my utter disbelief at my good fortune, I had to chuckle at the nurse's assumption that we were just starting to try. But then I realized, oh my God! We are starting to try!!!! I think I was in shock after I hung up. Seconds after telling my husband the news, I had to ask him, did that really happen? She might as well have told me I was pregnant.

What does this mean? Well, I assume it means my PCOS is under control (I say "assume" because I didn't speak directly with my doctor tonight, although he did tell me this was the case at my appointment last week, so I shouldn't be hesitant to write that). If I went off the medication and started eating normal again, it would come back. But for all intents and purposes, my hormones are behaving like someone who doesn't have PCOS right now.

When my doctor first told me I had PCOS, he said he'd treat me like he treats all his patients, but there's no guarantee I'd react how he hoped to the protocal. Some women do and some women don't. At my appointment last week he was actually excited because, he said, he lays out a treatment plan and when it works like it is supposed to, it's exciting. Now we know for certain it worked like it was supposed to. My body actually did what it was supposed to!!

So here we are. I'm not used to getting good news. The world seems a little brighter, like a dark cloud lifted. I'm not kidding. I know I still might never conceive (I'm a pessimist, don't forget.. or a "realist" as my husband so affectionately kept referring to me during our homestudy meeting today). And I know that my peak plus seven blood draw coming up this cycle might show a problem (although I have to believe if something is wrong with my progesterone, it wouldn't be as difficult a fix as what I've already overcome). But right now my hormones are back to normal, my prolactin is normal, my testosterone is normal and most importantly, my LH/FSH ratio that was crazy before is back to normal. For all this I thank God. I still don't know or understand his plan - and I know the ride is a lot easier to take when things are looking up - but we still have a long road ahead and I just hope that I can continue to trust in him the whole way.

Now I am going to go celebrate with some strawberries dipped in a little bit of chocolate.

Metformin and me

Ahhh! This metformin is really getting to me!

I'm sorry if I sound like a broken record, but I need to vent. I was a little nauseous this morning (it's technically Thursday morning right now, but I'm referring to Wednesday here), but was okay this afternoon. So I ate some low-carb pasta salad I made (lately, nearly-plain pasta is one of the only things that appeals to me) and took a pill. I actually felt good for a while and even ate some more pasta a couple hours later. Then, about four hours after taking the met the nausea set in. I'm starting to notice a trend - I feel sick 3-4 hours after each dose. Anyways, it got better but by then I had entered my no-food zone of 8:30 to 11:30. At midnight, I started to feel very ill and actually thought I was going to pass out, so I laid down (yes, I made my poor husband, who is recovering from surgery, get off the couch for me. It was that bad). At this point, I was due for another dose (just what I wanted!), so I forced myself to eat some toast and took the pill. Oh - and I've had horrible heart burn off and on all day.

So that's what my day looked like. I'm not sure if the fact that I'm eating very little is adding to my problem, or if it's that when I do eat I'm eating mainly carbs. I read somewhere that I should have some protein to help with the nausea, but I can't bring myself to make anything. My husband hasn't had much of an appetite either, but he's getting better each day so tomorrow I might try to make a balanced meal.

If this lasts another week or two, I might call my doctor and see if there's anything I can do, like switching to extended release. Right now I'm just grateful to God that I feel like I can handle this (even though it probably doesn't seem that way from this blog!). And even though we're not getting along too well at the moment, I'm still holding out hope that I will grow to love metformin once it is responsible for my first pregnancy!

I'm tired, too tired to think of a good title

I'm back in VA. I've got so much I should be doing, but instead I feel like taking a day to rest. Well, at least a half-day to rest. This morning my husband had a doctor's appointment for his leg pain. The doctor was much better than the ER (obviously) and thinks it is a problem with a disc, which is probably pinching a nerve. He ordered an MRI, and my husband got in right away because the doctor called it "urgent," due to the fact that my husband's leg showed signs of weakness. So hopefully we'll hear back today or tomorrow and we're hoping surgery isn't necessary, but if it is, we'll deal with it. I just want his pain to go away and for him to return to normal.

Meanwhile, I'm tired. That's just my overall mood right now. I've had this nagging feeling lately to handle this infertility stuff better and I'm trying. I really am. But right now I'm tired physically and emotionally.

On Sunday, we had an anniversary party for my grandparents and some of my cousins had their babies there (and I should add that one of those cousins isn't married, and the other two were married well after I was. That's always nice). One baby in particular hadn't been seen yet by most of the family so, of course, a big deal was made of it. I tried to handle it well, but I couldn't help but sit there at lunch, eating lettuce and scraping the fried coating off my chicken parmesan, feeling sorry for myself. It was so clear at that moment - I was sitting there, childless, unable to eat most of the food, while everyone else could have kids and a normal diet (I know food and pregnancy are no where near each other on the importance scale, but it just made for a stark contrast). Sometimes it just doesn't seem right at all.

So there I was at the party when all of a sudden I became acutely aware of one thing - I am unable to have kids. Has anything like that ever happened to you? It's happened to me in the past and always seems to come out of nowhere. Something I live with every day, something that is most definitely not new, just all of a sudden hits me hard. I am unable to have kids. I am that woman. This is my life. It's like it hits me in my heart with a force that I must find a way to supress every other moment, without even realizing it. It's almost like an out-of-body experience, where I am, for a second, looking at myself with new eyes. And it shouldn't surprise me, but it always does. Wait a minute, are you saying I'm unable to have kids? Un-able? Like, I'm barren? And I may never have a baby to bring to family parties? I wonder if anyone there noticed that I was completely out of it for a few minutes.

On the way home (when I was by myself, of course) I cried. But this time it wasn't in a bratty way, but because I just couldn't help it. After a few minutes, I dried my tears and went on with my day.

I know I won't be pregnant any time soon, I just pray it happens some time in the years to come. I think, for many, there is a point in the infertility struggle when you go from believing it could happen each month, to struggling to maintain a shred of hope each month, to knowing it won't happen for a long time, if ever. For me, the first phase of having monthly hope probably lasted a year and a half. The phase of trying to muster up some hope lasted through the remainder of year two, and then year three was when I realized it wasn't going to happen. I'm not saying it won't happen ever, but mine is a much bigger picture. Now the struggle becomes one of patience and how to handle what will likely be a long wait. So I'm now trying to focus on the small things - like that my chart looks much more normal, my temperature appears to be doing the right thing, and I'm on medication for PCOS. Things are looking up lately. Not for a pregnancy any time soon, but for a pregnancy some day.

Alright, sorry to ramble. My husband left the room a while ago and I'm hoping he fell asleep, but I should go see if he's okay. Hopefully I'll have some good news about him tomorrow.

We know what's wrong

Where to begin? I've decided that tonight I'm going to just post all the information I learned today at my appointment and not comment too much on it (or at least that's my plan). I just want to put it all out there and begin to process it. I will say, though, that I'm not sure how I feel about it right now. I go back and forth from being upset to being slightly hopeful. My husband, on the other hand, thinks everything we learned is great news, but I don't necessarily trust him. It's his job to say that. It's also kind of odd to finally, after all these years, know what is standing between me and having babies. Anyways, here goes...

I learned that from the blood taken at my last appointment on April 28, all my chemistry is good. I'm not anemic, my organs are good, and everything is normal. Also normal is my thyroid, my prolactin and my testosterone (my testosterone being normal was a big surprise because I thought that was high due to PCOS, which hadn't been treated at all when the blood was taken). It also showed that my LH and FSH ratio is still 2:1. That is bad and is a sign of PCOS.

We learned a lot from my saliva test (which was taken two cycles ago in May, and shows my hormones throughout the entire cycle). This is where it gets tricky, and this is where we learned what is truly the cause of my infertility. First off, I am ovulating (yes, I was shocked). At the beginning of the cycle, my estrogen starts good and my progesterone is low like it should be. Then all goes awry. You know how estrogen (or is it estradiol? whatever) goes down at the very same time that progesterone rises? I remember my Creighton teacher teaching me that and commenting on how amazing it is that God designed it so perfectly. Well, mine doesn't do that. My estradiol did whatever it's supposed to do to show that I'm ovulating, but then my progesterone didn't rise until about three days later. Three days! I think it's supposed to happen instantaneously. Then the progesterone got really high, like it's supposed to, but then it dropped off a few days before it should.

The doctor described my ovaries like this:

"You know how on Dancing With the Stars there's the really awesome couple who is smooth and in step and looks great? And then there's the goofy couple who is never quite in sync? Your ovaries are the goofy couple." He also used a golf analogy for my husband's benefit. Something about my ovaries not being like Tiger Wood's swing.

He said my ovaries are dysfunctional. I probably release an egg every month but instead of being this nice, smooth, precise process, it's slow and clunky and pretty messed up. So my ovaries are losers. They're ugly and dorky and probably get picked on by all my other organs.

He thinks the LH/FSH problem is causing it, and the whole ovarian dysfunction probably even caused my endometriosis.

It was at this point that he told me no one knows why this happens or how to treat it. He then said "this is when people do IVF" (he, of course, is against it, but just meant that this is when others would typically consider it their only option). So that was when I zoned out. I didn't hear much of anything else he said for a few minutes. I concentrated on holding back tears and I think I nodded my head a lot, probably inappropriately.

Somehow I came back around and picked back up when he was describing PCOS and insulin resistance. So I told him about my diet and weight loss (Oh my goodness! I didn't even tell you about my big weigh in! I did it! I met my goal, surpassed it even, and was down 16 pounds on his scale! Woo hoo!). His immediate response was "Praise the Lord!" He thought this was GREAT news and he thinks it is likely helping me already. He toyed with just treating me with diet and exercise. He had written out a prescription for metformin, and told me not to fill it right away. Then he changed his mind and said to fill it. He also doesn't think the drug will affect me negatively. He takes it himself and said it makes him feel whole again and will likely do the same for me. He also said that even if getting pregnant wasn't an issue for me, I need to treat this as a medical issue. It could lead to diabetes, heart disease or a heart attack at a younger than normal age.

On a sidenote, he said that metformin will likely make me lose even more weight, and faster. Looking forward to that! (And, hopefully, it won't be because I'm too nauseous to keep anything down! Please, Lord!)

So my doctor didn't come right out and say what my chances are of getting pregnant. He also didn't say it won't work. He basically just said that this happens to work for a lot of patients. He said it could take six to nine months to work, so we have a long wait ahead. He doesn't think surgery is in my future because apparently the wedge resection surgery is done to help lower the testosterone and, in turn, help the PCOS. Since my testosterone is already back to normal, that isn't my problem.

My next appointment is in four months. It's so far away that they're not even scheduling that far in advance, so I have to call in August. He also said that if by my next appointment it appears that the metformin is helping, he'll put me on either Clomid or Letrozole to help the ovulation. I'm hoping that combination will be what eventually leads to a pregnancy.

So that's it. I probably left some stuff out. For a recap: I am ovulating.. but my ovaries are bad.. my estrogen and progesterone don't switch off at the same time.. this somehow causes my egg to not do the right thing after leaving my ovary.. this is caused by my LH and FSH ratio being off.. this is all caused by insulin resistance (I didn't ask how).. and this is all part of PCOS.. my diet and exercise is likely helping to treat it already.. I'm going to start metformin tomorrow to help it as well.. but it will likely take at least six months before we even know if it's helping.. and if it is, he'll put me on clomid or something like it to help ovulation. I think that's it, but I have a feeling I'll remember something else in a little while and have to update this.

I would appreciate hearing what you think. Is this not that big of a deal? Have you ever heard of it (the estradiol/progesterone problem)? Is the situation more dire than I yet realize? Anyone know anyone who has fixed this problem and gotten pregnant?

I'm going to post tomorrow on how I feel about this. I will make a final observation, though. I left the appointment sure of one thing: If I do become pregnant, it will be through prayer. I feel now that nearly everything has been stripped away and I am left to lean on the Lord. I know I still have medication to try and my diet may help as well, but ultimately, whether any of that helps to correct my hormones is up to God. I know that it is always up to God, but for some reason I am now more accutely aware of this than ever before.

Current stats

Here they are: It's cycle day 29, I am 12 days post peak, I've had two days of very light brown spotting, my temp is still up (98.4 this morning), no bloating yet, no other pms symptoms to speak of, and bbs are a little sore still but they never outright hurt this cycle.

Here's my bbt chart. I took out one temp a few days ago because I had gotten up really early that day (that's okay, right? I'm new to this temp thing). I also woke up real early on day 27, so that could explain that little dip too.



Does anyone know if this chart looks good, bad or indifferent? As far as I know it at least means I won't be starting a new cycle today, right? I usually get my period after waking up with a low temp. I'm also wondering how my increased dose of T3 might be affecting my waking temp. I mean, the purpose of the medication is to raise your body temperature, and my dose increased on cd 23. I don't know, I'm pretty sure when I get my period my temp will drop like normal no matter what dose of T3 I'm on.

I think this is all working towards the inevitable - that I will be bloated when I weigh in at my doctor's appointment on Monday. Sorry, I obsess.

Speaking of my doctor's appointment, I want to start making a list of questions I need to ask him, so I figured I might as well do it here. So here's what I've got so far:

1. Will I have to go on Metformin for my PCOS? Can I take any precautions to prevent nausea?

2. Is there any way diet alone can help PCOS? (I don't want to waste any time, though, so an aggressive approach is fine by me)

3. Will you be testing to see what my insulin-resistance looks like after almost two months on the diet?

4. So far I've been following the G.I. diet. Do I need to tweak that at all to specifically help PCOS?

5. What will we be doing to get me ovulating? Any chance I did this month based on my chart?

6. Can you tell anything from my temps?

7. Can I please, pretty please, go off of the T3? (If, though, it is helping my infertility in any way, I'll stay on it)

8. Will I need surgery for my PCOS? Will I need another surgery for endometriosis?

That's what I have come up with so far, but I know I'm forgetting a lot. I'll have to update this list as I remember. Anything else you think I should ask?